Opiate crisis a long time coming

BOSTON - In March, Gov. Deval Patrick declared opiate abuse a public health emergency and announced plans to combat soaring rates of opiate addiction.He proposed increasing drug treatment funding by $20 million, tried to ban a new powerful painkiller and expanded a program to train and equip first responders with an overdose-reversal drug.The House and Senate followed with budget additions and other bills to improve access to drug treatment."We have an epidemic of opiate abuse in Massachusetts, so we will treat it like the public health crisis it is," Patrick said in a statement.But this newly declared crisis is not new. Department of Public Health statistics show the growth in opiate abuse and related deaths from heroin and prescription drugs began in the late 1990s and grew at much faster rates than it has in more recent years."This so-called 'crisis' is really a seven-or-eight-year trend that's gotten consistently worse every year and it directly correlates with what's going on with the prescription of different types of pain medication," said Lee Dalphonse, vice president of Seven Hills Behavioral Health, a treatment organization headquartered in Worcester.A closer look at the numbers shows an epidemic that began in the late 1990s and exploded over the past 14 years.Although repeated constantly in the media, the state police statistic of 185 overdose deaths from last November to February pales when compared to previous spikes in deaths. Between 2000 and 2006 the annual number of unintentional overdose deaths almost doubled from 338 to 615, according to the health department's own numbers.Although deaths for 2013 is estimated at an all-time high of 674 (the final number is still being tallied), it indicates a much less dramatic increase between 2006 and 2013 than in the previous six years between 2000 and 2006.The rate of opiate deaths increased from 5.3 to 9.5 per 100,000 Massachusetts residents from 2000 to 2006, according to the state statistics. The estimated rate for 2013 is 10.1 per 100,000 residents.Joanne Peterson, executive director of Learn to Cope, a statewide addiction support group, echoes other addiction experts who blame the rise in addiction rates and deaths on an increase in the availability of prescription pain relievers, such as OxyContin and Vicodin, which began in the mid-1990s."We have many that have been prescribed (prescription pills) for a legitimate condition and end up addicted," Peterson said. "When OxyContin was unleashed back in the late 90s, it really, really started a huge epidemic."OxyContin, a widely abused prescription painkiller, was introduced to the market in 1995. According to the Massachusetts Prescription Monitoring Program, the number of prescriptions for Schedule 2 opioids such as OxyContin steadily increased from about half a million in 1992 to about 4.5 million in 2012.The state began an online prescription monitoring program in December 2010 to track who is writing and receiving excessive amounts of opiates and other addictive drugs. But the program was voluntary; there was no mandated requirement.Another disturbing trend is tucked into the numbers. According to a 2011-2012 drug use survey by the United States Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), 8.9 percent of Massachusetts residents between 18 and 25 are likely abusing opiates - the highest percentage among any age group.The agency's statistical analysis points to numbers that could be as high as 11.1 percent, or as low as 7.2 percent of that age group.That trend is being seen nationwide. Since the early 2000s, the age group reporting the highest level of heroin use in the annual SAMHSA survey has shifted from the 35 to 49 cohort to those between 26 and 34.Romas Buivydas, vice president of clinical development for Worcester-based treatment center Spectrum Health Systems says the flood of prescription drugs introduced teens and younger, college-aged people to opiates, leading some to try heroin when they can no longer get prescription drugs."A new bunch of folks who have probably never, ever thought about using heroin, have started using heroin because it's more accessible," he said.As the use, and abuse, of pharmaceuticals grew, so did the increase in addiction. Between 1992 and 2002, the number of Massachusetts residents seeking treatment for opioid abuse other than heroin increased by 950 percent, according to the Cambridge-based Overdose Prevention and Education Network.At the same time the number of people in treatment for heroin addiction fell. According to the state health department's Bureau of Substance Abuse Services, admissions for heroin abuse treatment decreased in the early 2000s, hovering in the low 40,000s for several years before increasing again, reaching 48,000 in FY2012.The response to the crisis by the state has been slow and fragmented. Increases in funding for drug treatment were mostly tucked into earmarks added to legislation by individual state lawmakers. Funding for opiate treatment did not have a separate line in the state budget until 2010 - more than a decade after addiction rates began to climb.Now, 14 years after addiction numbers began their dramatic rise, elected state officials are taking more direct action.Since March, Patrick proposed adding $20 million to expand addiction treatment programs. The House voted to increase funding for substance abuse treatment programs from $85.6 million to $89.4 million. Earlier this month the Senate passed bills to insure insurance benefits and access to addiction treatment while budgeting $33 million for FY2015 in various treatment and education programs.Patrick also mandated prescription monitoring for doctors and pharmacies and asked the state's Interagency Council on Substance Abuse and Prevention to make recommendations in the next few months to better address the epidemic.And in an unusual move, Patrick tried to ban the new, powerfully addictive drug Zohydro, an opiate that is easily abused. His order was blocked by a federal judge. The case is expected to continue in the courts.Patrick also wants to expand the distribution of Narcan, an effective anti-overdose drug that has been used for years by EMT departments around the state. A newer form of the drug in a nasal spray will also be more widely distributed to friends and family members of addicts under the governor's proposal.Both the House and Senate Ways and Means Committees have included funding for the increased use of Narcan in their proposed FY2015 budgets.Ted Joubert, chief of the North Attleboro Fire Department and vice president of the Massachusetts Fire Chiefs Association, has been using the drug to counter overdoses since 1988."The great thing about Narcan is that there's a very quick response time. People are afraid to call first responders because they worry about their friend or family member being arrested, so there's a time delay, sometimes, between the overdose and when paramedics get there," said Joubert, who was recently appointed to a statewide task force on opiate addiction by the governor.The governor and the Legislature’s recent moves have raised hopes that state leaders are finally focusing on the opiate problem. But there are those who fear that focus will wane with time."There's a potential now with the government paying attention to these needs," Dalphonse said. "But there's also a degree of cynicism, where I say, 'Will this be another kind of situation where they pay attention to it for two or three months and then go back to some other issue and nothing really changes on the ground?'"This article was written by Chelsea Diana, Caitlin Fichtel and Jonathan Riley and reported by Diana, Fichtel, Riley, Lauren Dezenski, Allie DeAngelis, Dan Petersen and Max Lewontin, all students in the Boston University Statehouse Program.

Market Place

Original content available for non-commercial use under a Creative Commons license, except where noted.
MetroWest Daily News, Framingham, MA ~ 33 New York Ave., Framingham, MA 01701 ~ Privacy Policy ~ Terms Of Service